Clin Dx-Hematopathology
Terms
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- Stored form of iron
- Ferritin and hemosiderin
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Dec'd FE saturation
Inc'd transferrin synthesis
Inc'd TIBC
Dec'd Ferritin
Microcytic anemia - FE def. Anemia
- Most common cause of FE def. anemia? Children?
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Blood loss
Diet - Sns of FE def. Anemia
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fatigue,SOB,PICA
glossitis - Lab results of FE def. anemia
-
inc'd RDW
microcytic
hypochromic
retic response - Tx for FE def. anemia?
- Feosol(FE supplement)
- Atrophy of gastric mucosa = dec'd intrinsic factor=dec'd absorption of B12 = immature RBCs,megaloblastic
- Vit. B12 deficiency
- Risks for Vit B12 deficiency
- old age,vegan diet, alcoholism
- Lab results for pernicious anemia?
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hypersegmented neutrophils, HOWELL JOLLY bodies(DNA reminant)
Shilling test - Abnormal alpha or beta subunits of hemoglobin
- Hemoglobinopathies
- Substituion of valine for glutamate
- sickle cell
- Deficiency or absence of subunit,mediteranean ancestry
- Thalassemia
-
Autosomal recessive
Inflexible,rigid cells
Mechanical obstruction, painful swelling,priapism - Sickle Cell
-
Lab reveals sickle cells
Sickle dex
Hemoglobin electrophoresis(gold standard) - Sickel Cell
-
Gene deletion
Gene mutation -
alpha thalassemia
beta thalassemia -
Alpha thal major -->
Beta thal major --> -
Bart's
Cooley's - LAb for Thalassemia
-
RDW to dif. dx from IDA
Hemoglobin electrophoresis -
DEc'd in all cell lines due to damage of hematopoietic stem cells
Caused by toxic exposure - aplastic anemia
- Labs for aplastic anemia
-
pancytopenia,hematuria
bone marrow biopsy -
Fe overload due to inc'd FE absorption in gut, >20 g
Hepatoma risk - Hemochromatosis
- Lab for hemochromatosis
- Ferritin inc'd >300 males, >120 females
- Tx for hemochromatosis
- phlebotomy
-
"Pruritis after bathing" h/a,tinnitus
Inc'd CFU, inc'd viscosity, dec'd cerebral flow - Polycythemia Vera
-
Seen it pts with underlying disease condition
Inc'd production of lactoferrin - Anemia of chronic disease
- Tx for anemia of chronic disease
- Treat underlying condition, no supplements
-
RBC cannot deal with oxidative changes, hemoglobin accumlates in RBC
Jaundice,splenomegaly,dizzy - G6PD deficiency
- Labs for G6PD deficiency
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HEinz bodies
Helmet cells - Autoimmune hemolysis (2)
-
anti-RBC IgG (warm reacting)
IgM (cold reacting)
both causing hemolysis -
Spherocytes,splenomegaly,reticulocytes
Defect in RBC that get destroyed by spleen - Hereditary Spherocytosis
-
Leukemias
a. nuclei bigger ratio to cytoplasm
b.mature cell in smear -
a. acute
b. chronic - Lab for Leukemia
- Bone marrow aspirations containing spicules
-
T or B cell, 80% childhood
bone marrow taken over by lymphocytic cells - Acute LYmphocytic Leukemia
- Tx for ALL
- chemo, BM transplant
- Common in adults, Auer rods in lab
- Acute myelogenous leukemia
- Mature myeloid cells, PHiladelphia chromosome
- Chronic myelogenous leukemia
- Lab for CML
- Southern blot tests
- Similiar to CML but presents with inc'd LAP
- Leukemoid rxn
-
Disorder of mature B cells, autoimmunity to RBCs
Lab shows Smudge Cells - Chronic lymphocytic leukemia
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B cells have fine hairlike projections
Splenomegaly
Lab show hair cells,red pulp - Hairy cell Leukemia
-
Macrophage cancer, bimodal
Lab shows: Reed Sternberg cells - Hodgkins lymphoma
-
Lymphocyte cancer, poor prognosis
Lab:Lymphnode bx - Non-hodgkins lymphoma
- Similiear to NHL, affects B cells, associated with chromosome 8-14 translocation
- Burkitts Lymphoma
-
Plasma and monoclonal neoplastic proliferation
IgG spikes
Bence Jones proteins in urine
SPEP-paraproteins
Inc'd serum calcium - Multiple Myeloma
-
Inc'd IgM, spike
Rouleaux formation in RBC
Hyperviscosity
Tx:Plasmapharesis - Waldenstroms Macroglobulinemia
-
NEoplastic CD4 T cells
Infiltrates dermis and epidermis
Skin bx - Mycosis Fungoides